陆军军医大学(第三军医大学)大坪医院战伤休克与输血研究室,创伤与化学中毒全国重点实验室,重庆
LI Tao E-mail:lt200132@tmmu.edu.cn
Received:02 November 2025,
Revised:2025-12-05,
Accepted:15 December 2025,
Published:15 January 2026
移动端阅览
吴跃,朱娱,李清晖,等.高原、高寒、高热环境下致死性休克大鼠模型的建立与标准化造模方式筛选[J].陆军军医大学学报,2026,48(01):63-74.DOI:10.16016/j.2097-0927.202511007.
WU Y,ZHU Y,LI Q H,et al.Establishment and standardized modeling of lethal shock rat models in high-altitude, high-cold, and high-heat environments[J].J Army Med Univ,2026,48(01):63-74.DOI:10.16016/j.2097-0927.202511007.
吴跃,朱娱,李清晖,等.高原、高寒、高热环境下致死性休克大鼠模型的建立与标准化造模方式筛选[J].陆军军医大学学报,2026,48(01):63-74.DOI:10.16016/j.2097-0927.202511007. DOI:
WU Y,ZHU Y,LI Q H,et al.Establishment and standardized modeling of lethal shock rat models in high-altitude, high-cold, and high-heat environments[J].J Army Med Univ,2026,48(01):63-74.DOI:10.16016/j.2097-0927.202511007. DOI:
目的
2
基于本实验室已建立的常规环境大鼠失血性休克模型,建立高原、高寒、高热特殊环境大鼠致死性休克模型,为特殊环境下致死性休克救治相关研究提供动物模型。
方法
2
864只12周龄、体质量(200±20)g SPF级雄性SD大鼠按不同预处理环境分为4组(
n
=216):高原环境组[低压氧舱模拟4 000 m海拔,(22±2)℃暴露48 h];高寒环境组(海拔200~300 m,-20 ℃暴露6 h);高热环境组(海拔200~300 m,35 ℃暴露12 h),常规环境对照组(不做环境预处理)。环境预处理后,采用4种脾损伤方式诱导腹腔自由出血制备非控制性失血性休克模型:①距脾实质末端3 cm处离断;②距脾实质末端3 cm和5 cm处分别离断;③脾尾端小动脉分支离断;④脾尾端小动脉分支离断联合距脾实质末端3 cm处离断,直至平均动脉压(mean arterial pressure,MAP)降至40 mmHg即判定模型制备成功。模型成功后,用乳酸林格氏液(lactated Ringer’s solution,LR)低压维持MAP在50~60 mmHg 1 h,经脾动脉结扎彻底止血后,按出血量2倍体积LR进行确定性复苏。监测MAP、呼吸频率(respiratory rate,RR)、心率(heart rate,HR),检测心功能[肌钙蛋白I(troponin I, TnI)]、肝功能[谷草转氨酶(aspartate aminotransferase,AST)、谷丙转氨酶(alanine aminotransferase, ALT)]、肾功能[血尿素氮(blood urea nitrogen, BUN)、血清肌肝(serum creatinine,Scr)],观察大鼠存活时间及6 h存活率,筛选各环境适配的造模方式。用各环境组筛选出的造模方式分别在相应环境预处理的巴马香猪上制备失血性休克模型,并按前述治疗方案确定性复苏后,观察巴马香猪基础生理指标(MAP、RR、HR)、器官功能(心、肝、肾)及存活情况,以验证造模方式稳定性。
结果
2
不同环境致死性休克模型的适配造模方式存在差异:常规环境优选重度血管联合实质损伤的方式④,高原环境优选重度血管损伤的方式③,高寒环境优选轻度实质损伤的方式①,高热环境优选中度双位点实质损伤的方式②,上述方式均满足休克后6 h致死率
>
70%、低压复苏后失血量
>
50%、确定性复苏后存活率
>
50%的模型标准。休克状态下,各组大鼠MAP显著降低(
P
<
0.001),RR、HR异常改变,心、肝、肾器官功能指标(TnI、AST、ALT、BUN、Scr)显著升高(
P
<
0.05),存活时间缩短;经LR低压复苏联合确定性复苏后,MAP显著回升(
P
<
0.01),器官功能指标显著改善,存活时间延长。巴马香猪验证结果显示:休克组MAP降至约40 mmHg,RR显著降低,HR升高,6 h存活率为0,心、肝、肾器官功能指标(TnI、AST、ALT、BUN、Scr)显著升高(
P
<
0.001);复苏组MAP显著升高至58.6~68.4 mmHg(
P
<
0.01),器官功能明显改善,6 h存活率达50.00%~56.25%,模型可靠性得到确认。
结论
2
成功建立了高原、高寒、高热环境下致死性休克模型,明确了各环境对应的标准化造模方式;经巴马香猪验证,模型稳定性与可靠性符合实验要求。
Objective
2
To establish lethal shock models in high-altitude
high-cold
and high-heat environments based on the conventional environment hemorrhagic shock (HS) model established in our laboratory
in order to provide animal models for lethal shock treatment in special environments.
Methods
2
A total of 864 SPF-grade male SD rats (12 weeks old
weighing 200±20 g) were divided into high-altitude environment group (simulated 4 000 m altitude in a low-pressure oxygen chamber
exposed to 22±2 ℃ for 48 h)
high-cold environment group (altitude 200 to 300 m
exposure to -20 ℃ for 6 h)
high-heat environment group (altitude 200 to 300 m
exposure to 35 ℃ for 12 h)
and conventional environment control group (no environmental pretreatment) according to different environmental pretreatment
with 216 animals in each group. After environmental pre-conditioning
4 types of spleen injury methods were used to induce free intra-abdominal bleeding to construct corresponding uncontrolled HS model. The injury methods were as follows: ① Transverse transection at 3 cm away from the end of the splenic parenchyma; ② Transverse transection separately at 3 and 5 cm away from the end of the splenic parenchyma; ③ Transverse arteriotomy of a small arterial branch at the splenic tail; ④ Transverse arteriotomy of a small arterial branch at the splenic tail combined with transection at 3 cm away from the end of the splenic parenchyma. Free intra-abdominal bleeding was induced by above 4 methods until the mean arterial pressure (MAP) dropped to 40 mmHg
which was defined as successful establishment of the uncontrolled HS model. After successful modeling
lactated Ringer’s (LR) solution was employed to maintain MAP at 50 to 60 mmHg at low pressure for 1 h. After the splenic artery was ligated for complete hemostasis
definitive resuscitation was obtained with LR solution of 2×blood loss volume. MAP
respiratory rate (RR) and heart rate (HR) were monitored
cardiac function [troponin I (TnI)]
liver function [aspartate aminotransferase (AST), alanine aminotransferase(ALT)]、and renal function [blood urea nitrogen (BUN), serum creatinine (Scr)] were evaluated
survival time was observed
and 6-hour survival rate was calculated to screeen the appropriate modeling methods for each environment. Then the obtained modeling methods were applied on Bama pigs to establish HS models for high-altitude
high-cold
and high-heat environments
respectively. After modelling
the pigs were resuscitated according to the aforementioned treatment regimens
and basic physiological indicators (MAP
RR
HR)
organ functions (heart
liver
kidney)
and survival status were observed to verify the stability of the modeling methods.
Results
2
There were differences in the appropriate modeling methods for different environments: the conventional environment preferred method ④
the high-altitude environment preferred method ③
the high-cold environment preferred method ①
and the high-heat environment preferred method ②. All the above methods met the model standards of a 6-hour mortality rate
>
70% after shock
a blood loss
>
50% after low-pressure resuscitation
and a survival rate
>
50% after definitive resuscitation. In the state of shock
the MAP of rats was significantly reduced in each group (
P
<
0.001)
RR and HR were abnormally changed
the indicators of cardiac
liver
and renal functions (TnI
AST
ALT
BUN
Scr) (
P
<
0.05) were significantly increased
and the survival time was obviously shortened. After LR low-pressure resuscitation combined with definitive resuscitation
the MAP was notably recovered (
P
<
0.01)
the organ function indicators were significantly improved
and the survival time was greatly prolonged. The verification results in Bama miniature pigs showed that
in the shock group
MAP was decreased to approximately 40 mmHg
RR was significantly reduced
HR was increased
the 6-hour survival rate was 0%
and the indicators of cardiac
liver
and renal functions (TnI
AST
ALT
BUN
and Scr) were notbly elevated (
P
<
0.001). In the resuscitation group
the MAP was significantly increased to 58.6 to 68.4 mmHg (
P
<
0.01)
the 6-hour survival rate reached 50.00% to 56.25%
and organ functions were significantly improved. All these findings confirmed the reliability of each model.
Conclusion
2
Lethal shock models under high-altitude
high-cold
and high-heat environments are successfully established
respectively
and the appropriate standardized modeling methods are identified for each environment. The modelling methods are further verified on Bama miniature pigs
and the constructed models have advantages of stability and reliability for laboratory requirements.
CARSETTI A , ANTOLINI R , CASAROTTA E , et al . Shock index as predictor of massive transfusion and mortality in patients with trauma:a systematic review and meta-analysis [J]. Crit Care , 2023 , 27 ( 1 ): 85 . DOI: 10.1186/s13054-023-04386-w http://dx.doi.org/10.1186/s13054-023-04386-w .
KORNBLITH L Z , MOORE H B , COHEN M J . Trauma-induced coagulopathy:The past, present, and future [J]. J Thromb Haemost , 2019 , 17 ( 6 ): 852 - 862 . DOI: 10.1111/jth.14450 http://dx.doi.org/10.1111/jth.14450 .
ZHAO J X , YOU G X , YIN Y J , et al . Acute high-altitude exposure shortens survival after uncontrolled hemorrhagic shock in rats [J]. J Surg Res , 2018 , 226 : 150 - 156 . DOI: 10.1016/j.jss.2018.01.028 http://dx.doi.org/10.1016/j.jss.2018.01.028 .
ZHU Y , MA S , DENG H Y , et al . The characteristics of organ function damage of hemorrhagic shock in hot environment and the effect of hypothermic fluid resuscitation [J]. Shock , 2022 , 57 ( 4 ): 526 - 535 . DOI: 10.1097/SHK.0000000000001873 http://dx.doi.org/10.1097/SHK.0000000000001873 .
ZHOU Y Q , LI Q H , XIANG X M , et al . Low-dose norepinephrine in combination with hypotensive resuscitation may prolong the golden window for uncontrolled hemorrhagic shock in rats [J]. Front Physiol , 2022 , 13 : 1004714 . DOI: 10.3389/fphys.2022.1004714 http://dx.doi.org/10.3389/fphys.2022.1004714 .
HU Y , FANG H , TAN L , et al . The mitochondrial division inhibitor mdivi-1 protected organ function and extended the treatment window in rats with uncontrolled hemorrhagic shock [J]. Shock , 2025 , 63 ( 3 ): 474 - 486 . DOI: 10.1097/SHK.0000000000002459 http://dx.doi.org/10.1097/SHK.0000000000002459 .
何霜霜 , 朱娱 , 周赫男 , 等 . 周细胞对失血性休克大鼠血管通透性的保护作用 [J]. 第三军医大学学报 , 2020 , 42 ( 19 ): 1882 - 1889 . DOI: 10.16016/j.1000-5404.202004227 http://dx.doi.org/10.16016/j.1000-5404.202004227 .
HE S S , ZHU Y , ZHOU H N , et al . Protective effect of pericytes against vascular leakage in rats with hemorrhagic shock [J]. J Third Mil Med Univ , 2020 , 42 ( 19 ): 1882 - 1889 . DOI: 10.16016/j.1000-5404.202004227 http://dx.doi.org/10.16016/j.1000-5404.202004227 .
张连阳 , 李阳 . 创伤失血性休克进展 [J]. 临床急诊杂志 , 2018 , 19 ( 03 ): 145 - 148 . DOI: 10.13201/j.issn.1009-5918.2018.03.001 http://dx.doi.org/10.13201/j.issn.1009-5918.2018.03.001 .
ZHANG L Y , LI Y . Progression for traumatic hemorrhagic shock [J]. J Clin Emerg , 2018 , 19 ( 03 ): 145 - 148 . DOI: 10.13201/j.issn.1009-5918.2018.03.001 http://dx.doi.org/10.13201/j.issn.1009-5918.2018.03.001 .
曹国征 , 晋菲斐 , 王天兵 . 严重创伤失血性休克患者液体管理的现状及治疗进展 [J]. 创伤与急诊电子杂志 , 2025 , 13 ( 1 ): 25 - 31, 38 . DOI: 10.16746/j.cnki.11-9332/r.2025.01.004 http://dx.doi.org/10.16746/j.cnki.11-9332/r.2025.01.004 .
CAO G Z , JIN F F , WANG T B . Current situation and treatment progress of fluid management in patients with severe traumatic hemorrhagic shock [J]. J Trauma Emerg Electron Version , 2025 , 13 ( 1 ): 25 - 31, 38 . DOI: 10.16746/j.cnki.11-9332/r.2025.01.004 http://dx.doi.org/10.16746/j.cnki.11-9332/r.2025.01.004 .
徐乾 , 周邦富 , 贺丽 , 等 . 振动条件对大鼠非控制性失血性休克模型生理功能的影响 [J]. 军事医学 , 2020 , 44 ( 6 ): 401 - 405 . DOI: 10.7644/j.issn.1674-9960.2020.06.001 http://dx.doi.org/10.7644/j.issn.1674-9960.2020.06.001 .
XU Q , ZHOU B F , HE L , et al . Effects of whole-body vibration conditions on physiological function of rats with uncontrolled hemorrhagic shock [J]. Mil Med Sci , 2020 , 44 ( 6 ): 401 - 405 . DOI: 10.7644/j.issn.1674-9960.2020.06.001 http://dx.doi.org/10.7644/j.issn.1674-9960.2020.06.001 .
郑强 , 温天明 , 舒其琛 , 等 . 米诺环素抑制5-脂氧合酶对未控制失血性休克大鼠肝组织的保护作用 [J]. 实用医学杂志 , 2021 , 37 ( 20 ): 2602 - 2607 . DOI: 10.3969/j.issn.1006-5725.2021.20.007 http://dx.doi.org/10.3969/j.issn.1006-5725.2021.20.007 .
ZHENG Q , WEN T M , SHU Q C , et al . Minocycline inhibits 5-lipoxygenase to protect the liver tissue of rats with uncontrolled hemorrhagic shock [J]. J Pract Med , 2021 , 37 ( 20 ): 2602 - 2607 . DOI: 10.3969/j.issn.1006-5725.2021.20.007 http://dx.doi.org/10.3969/j.issn.1006-5725.2021.20.007 .
郭淑芬 , 邓伟强 , 袁善桃 . 不同方法液体复苏对非控制性失血休克结局的影响 [J]. 中外医学研究 , 2020 , 18 ( 9 ): 133 - 135 . DOI: 10.14033/j.cnki.cfmr.2020.09.052 http://dx.doi.org/10.14033/j.cnki.cfmr.2020.09.052 .
GUO S F , DENG W Q , YUAN S T . Effects of different methods of fluid resuscitation on outcome of uncontrolled hemorrhagic shock [J]. Chin Foreign Med Res , 2020 , 18 ( 9 ): 133 - 135 . DOI: 10.14033/j.cnki.cfmr.2020.09.052 http://dx.doi.org/10.14033/j.cnki.cfmr.2020.09.052 .
班定宏 . 对出血未得到控制的失血性休克患者进行限制性液体复苏治疗的效果分析 [J]. 当代医药论丛 , 2020 , 18 ( 3 ): 32 - 33 . DOI: 10.3969/j.issn.2095-7629.2020.03.022 http://dx.doi.org/10.3969/j.issn.2095-7629.2020.03.022 .
BAN D H . Analysis of the effect of limited fluid resuscitation on patients with hemorrhagic shock whose bleeding is not controlled [J]. Contemp Med Forum , 2020 , 18 ( 3 ): 32 - 33 . DOI: 10.3969/j.issn.2095-7629.2020.03.022 http://dx.doi.org/10.3969/j.issn.2095-7629.2020.03.022 .
XU J , YU W T , LI N , et al . The impact of high-altitude and cold environment on brain and heart damage in rats with hemorrhagic shock [J]. Brain Circ , 2024 , 10 ( 2 ): 174 - 183 . DOI: 10.4103/bc.bc_24_24 http://dx.doi.org/10.4103/bc.bc_24_24 .
李林 , 胡海姣 , 刁玉刚 . 损伤控制性复苏对低温失血性休克大鼠全脑缺血-再灌注损伤保护作用 [J]. 创伤与急危重病医学 , 2019 , 7 ( 2 ): 82 - 84, 87 . DOI: 10.16048/j.issn.2095-5561.2019.02.06 http://dx.doi.org/10.16048/j.issn.2095-5561.2019.02.06 .
LI L , HU H J , DIAO Y G . Protective effects of damage control resuscitation on global cerebral ischemia-reperfusion induced by hypothermia hemorrhagic shock in a rat model [J]. Trauma Crit Care Med , 2019 , 7 ( 2 ): 82 - 84, 87 . DOI: 10.16048/j.issn.2095-5561.2019.02.06 http://dx.doi.org/10.16048/j.issn.2095-5561.2019.02.06 .
曹惠鹃 , 孙佳 , 张铁铮 , 等 . 损伤控制性复苏对低温环境下失血性休克猪凝血功能影响 [J]. 临床军医杂志 , 2021 , 49 ( 9 ): 974 - 977 . DOI: 10.16680/j.1671-3826.2021.09.07 http://dx.doi.org/10.16680/j.1671-3826.2021.09.07 .
CAO H J , SUN J , ZHANG T Z , et al . Effect of damage-controlled resuscitation on coagulation function of hemorrhagic shock pigs in low temperature environment [J]. Clin J Med Off , 2021 , 49 ( 9 ): 974 - 977 . DOI: 10.16680/j.1671-3826.2021.09.07 http://dx.doi.org/10.16680/j.1671-3826.2021.09.07 .
PROCTOR E A , DINEEN S M , VAN NOSTRAND S C , et al . Coagulopathy signature precedes and predicts severity of end-organ heat stroke pathology in a mouse model [J]. J Thromb Haemost , 2020 , 18 ( 8 ): 1900 - 1910 . DOI: 10.1111/jth.14875 http://dx.doi.org/10.1111/jth.14875 .
WU Y , LI Q H , ZHU Y , et al . Effects of mdivi-1 on extending the golden treatment time following hemorrhagic shock in hot environment in rats [J]. Adv Biol , 2023 , 7 ( 7 ): e2300024 . DOI: 10.1002/adbi.202300024 http://dx.doi.org/10.1002/adbi.202300024 .
吴跃 , 朱娱 , 周远群 , 等 . 线粒体分裂抑制剂Mdivi-1对高原战创伤休克大鼠的保护作用 [J]. 陆军军医大学学报 , 2022 , 44 ( 20 ): 2030 - 2036 . DOI: 10.16016/j.2097-0927.202205040 http://dx.doi.org/10.16016/j.2097-0927.202205040 .
WU Y , ZHU Y , ZHOU Y Q , et al . Protective effects of mitochondrial fission inhibitor, Mdivi-1, on traumatic shock rats at high altitude [J]. J Army Med Univ , 2022 , 44 ( 20 ): 2030 - 2036 . DOI: 10.16016/j.2097-0927.202205040 http://dx.doi.org/10.16016/j.2097-0927.202205040 .
金辰 , 徐东刚 . 失血性休克动物模型研究进展 [J]. 军事医学 , 2017 , 41 ( 1 ): 73 - 76 . DOI: 10.7644/j.issn.1674-9960.2017.01.017 http://dx.doi.org/10.7644/j.issn.1674-9960.2017.01.017 .
JIN C , XU D G . Evolution of animal models of hemorrhage shock [J]. Mil Med Sci , 2017 , 41 ( 1 ): 73 - 76 . DOI: 10.7644/j.issn.1674-9960.2017.01.017 http://dx.doi.org/10.7644/j.issn.1674-9960.2017.01.017 .
0
Views
0
下载量
0
CSCD
Publicity Resources
Related Articles
Related Author
Related Institution
京公网安备11010802024621
